Recovery Focused Nursing Care Plan: Mental Health and Trauma

This assignment presents a detailed recovery-focused nursing care plan for a 31-year-old woman, Rachelle, experiencing postpartum depression, anxiety, and suicidal ideations following the birth of her daughter. The care plan addresses multiple issues, including severe depression, self-care deficits, and challenges with daily activities and work. It utilizes the HONOS scale for assessment and identifies the consumer's strengths, such as self-awareness and family support, to develop interventions. These interventions include cognitive behavioral therapy, schema and dialectical behavioral therapy, art therapy, and interpersonal therapy, implemented by a multidisciplinary team. The plan outlines specific goals, interventions, responsible parties, and timeframes for each identified issue, aiming to improve the consumer's mental health, self-care abilities, and social functioning. The assignment emphasizes a recovery-oriented approach, incorporating the consumer's strengths and promoting a holistic approach to mental health care, with references to relevant research supporting the chosen interventions.

Running head: MENTAL HEALTH, TRAUMA AND RECOVERY
MENTAL HEALTH, TRAUMA AND RECOVERY
Name of Student
Name of University
Author note

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MENTAL HEALTH, TRAUMA AND RECOVERY
Case study – Rachel
Rachelle is thirty one years old who, after the birth of her daughter Claire, is suffering
from postpartum depression. She had a depression with peri-partum onset and suffering from
worthlessness and hopelessness feelings as a mother. She is a catholic by religion and she had
been working really hard in private school for nine years. She used to be an organised,
focussed person.
 Over the ten weeks of the post-partum period – she has been suffering from
dysphoria, feelings of low self-esteem, self-guilt not having been able to care properly
for the baby as a mother
 Rachelle has social isolation, bonding issues with her daughter along with anhedonia
 Rachelle had lactation issues that triggered negative feelings
 Rachelle has self-identity and role confusion issues as a mother
 Rachelle has been suffering from severe anxiety attacks especially in daytime chiefly
triggered by two traumatic events – firstly the death of her brother about six months
ago. Secondly, her elder sister who is divorced, thirty seven years old and was
diagnosed with cancer -impacted her.
 Rachelle has self-care deficits and is lacking nutrition
 She has suicidal ideations
HONOS Result
Domain
1. Overactive, aggressive,
disruptive behaviour.
0
2. Non‐accidental self‐injury 2
3. Substance use and misuse. 0
4. Cognitive problems
3

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MENTAL HEALTH, TRAUMA AND RECOVERY
4. Physical illness or disability
problems
1
6. Hallucinations or delusions 0
7. Depressed mood 4
8. Other mental health issues 3
9. Relationships 2
10. Activities of daily living 4
11. Problems with living conditions 1
12. Problems with occupation and
activities
4
Consumers
Priority
Identified
Goals/Issues
The consumer’s
strengths to
address these
issues
Consumer and
Nursing
Interventions
Person/s
Responsible
Timefra
me
The
consumer
has lost
self-esteem
as she is
not being
able to acre
for her
baby. She is
Issue 1:
Very severe or
severe
depression. As
she thinks she
lacks the
properly
parental and
caring skills for
Strengths 1
 She is aware of
her physical
and her own
psychological
condition. As
she is aware to
her own self
and condition –
Interventions 1
 A mental
health
nurse along
with the
clinical
psychologis
t should
start with
Responsibility
1
The family of
Rachelle, the
mental health
nurse who is
attending her
along with the
other
Timefra
me 1
Daily
assessm
ents are
very
importan
t to help
the

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MENTAL HEALTH, TRAUMA AND RECOVERY
suffering
from major
depressive
disorder,
has
extreme
dysphoria
as well as
post-
traumatic
stress
condition
as well
pertaining
to the
death of
her brother
and cancer
detection
of her
sister.
Consumer
Priority 1 #
her daughter
and negative
perception
about her own
self has
distorted her
self-image and
added to
anhedonia and
the lack of
self-esteem
plus the
feelings of
self-guilt has
added to the
feelings of
more
depression
and anxiety in
the patient.
The death of
her brother
about six
months ago
and the
detection of
cancer in her
sister has
increased the
chance of self-
harm and
suicide
ideations in
the subject as
she is greatly
traumatized
by these
adverse
events. She
has suicidal
ideations
Goal 1 :
she can
definitely use
this self -
realisation as a
strength
towards her
recovery
(Karyotaki et
al., 2017)
 She has her
family with
her. Her
husband and
her mother is
taking care of
her while she is
not being able
to take care of
the household.
She can use
this family
support as a
huge strength
with respect to
her present
and future
condition.
 She is just 31
years old and
as she is not
yet middle
aged, she can
actually use
her physical
strength and
mental
determination
to guide her
own self
through the
self-recovery
phase.
 As it is just 10
cognitive
behavioural
therapy and
constantly
assess the
subject
with Beck’s
depression
inventory
(Chaves et
al., 2017)
 Administeri
ng the right
anti
depressive
medications
in
collaboratio
n with a
psychiatrist
is critical
 Providing
stress and
trauma
informed
care is very
important
 For her self-
harm
ideations -
schema and
dialectical
behavioural
therapy
should be
given
(Bazari,
Farahani &
Vatankhah,
2019)
 Harmful
objects
should be
members of
the
multidisciplina
ry team should
take the
responsibility.
subject
come
out of
depressi
on and
reconnec
t to her
positive
surround
ing and
the self-
harm
ideations
should
be kept
in check
daily.

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MENTAL HEALTH, TRAUMA AND RECOVERY
HONOS score -
4
weeks that her
baby is born
and not much
time has
lapsed, she has
enough time to
get back to
normal course
of maternity
and child care,
thus being able
to again care
for the child
kept away.
The
subjects is
hopeless
about her
own self
that has
resulted in
severe self-
care
deficits in
the subject
Consumer
priority 2#
Issue 2:
Incapacity to
perform nearly
at the
activities of
daily life and
in this Rachel
is having
problems with
eating, taking
care of the
household.
She is unable
to do the day
to day chores
of the house
properly as
she has severe
self -care as
well as
complex skill
development
issues.
The subject
has
complained of
a dysphoria
Strengths 2
 The subject has
her family
especially her
husband and
her mother
who support
her through
this adverse
condition that
has affected
her following
the childbirth
 She is staying
in her own
home and she
already knows
the home
environment
which is again
a personal
strength as
because it is
more to train
her activities of
daily life
deficits in a
Interventions 2
 Journal
keeping is
an
important
interventio
n of self-
recording
one’s own
emotional
changes
and anxiety
causes and
the nurse
can
intervene
the
situation
with the
same tool.
Expression
of
repressed
feelings
would help
her come
out
Responsibility
2
The art
therapist, the
mental health
nurse and the
patient are the
most
important
stakeholders in
these
intervention
and take full
responsibility
of their roles
Timefra
me 2
Art
therapy
classes
can be
undertak
en for
twice to
thrice a
week
And the
journal
should
be
evaluate
d by the
nurse on
a weekly
basis.
Self-care
deficits
and
improve
d should
be assed

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MENTAL HEALTH, TRAUMA AND RECOVERY
and feeling of
uselessness,
worthlessness
as well as a
strong sense
of pessimism
that has
prevented her
doing or
rather untaken
the self-care
skills such as
taking care of
each other.
She looked
dishelleved
which is
indicative of
her self-care
skills and as
she is having
issues with the
undertaking of
the activities
of daily life.
This can lead
to more
stagnancy in
life and block
to self -
development
and more
depression.
Goal 2 :
HONOS score
4
known
environment.
Being
habituated to
the physical
and social
environment at
home – she is
more
comforted and
the
psychosocial
safety is
subconsciously
present.
 The fact that
she has been
working for her
family in the
same house for
quite a long
time, the
learning and
the experience
that she
already has is
also an
important
strength.
depression
and get
back to her
normal
(Driessen et
al., 2016)
 In addition
to an art
therapist,
her trauma
related
depression
can
intervened
with art
therapy and
constant
motivation
by the
nurse can
improve
her self-
caring and
activities of
daily life
skills. Art
therapy will
improve
concentrati
on and
attention
(Ugurlu et
al., 2016)
 Family
support and
family
counselling
is
important.
daily.
Issue 3: Strengths 3
 She is in the
Interventions 3
 The nurse
Responsibility
3
Timefra
me 3

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MENTAL HEALTH, TRAUMA AND RECOVERY
Rachelle
Is not
preparing
well to
return to
her work
that she
was once
of fond of
and she has
anhedonia
as well that
is affecting
her social
life and
depression
in a
negative
manner
Consumer
priority 3#
Severe issues
with the
daytime work
and activities as
seen in the
subject as well.
The subject has
anhedonia and
social distancing
has made her
that is the
subject very
isolated from
her
surroundings.
Rachelle has
shown social
withdrawal
from her family
members and
for her friends
and
acquaintances
as well. She is
not preparing
well to return to
her work and
occupation has
well which is
complex
concerning
problem as
well.
Goal 3 :
HONOS score -
4
psychosocial
stage of
intimacy versus
isolation
( according to
Erik Erikson’s
stages of
psychosocial
development )
and as she
already has her
family with her
and she is not
truly alone or
isolated – the
situation
should act as a
strength
 She is
educated,
health literate
and she has
worked
professionally
for nice years
now and
therefore she
can use these
interpersonal
and
intrapersonal
skills address
her social
distancing
issues
should
collaborate
with an
occupation
al therapist
to help her
with the
occupation
al skills
developme
nt and the
motivation
the subject
requires to
return to
her work
(Berberian,
Walker&
Kaimal,
2019)
 Interperson
al therapy
to treat her
social
distancing
and social
isolation
can be
given by
the nurse in
collaboratio
n with the
clinical
psychologis
t.
The mental
health nurse,
clinical
psychologist
and the family,
occupational
therapist plus
friends of the
subject should
be taking the
responsibility
of helping the
subject get
back to her
work and take
care of her
baby as well.
Interpers
onal
therapy
can
administ
ered
twice a
week
with
alternate
day
assessm
ent of
the
social
skills
develop
ment.

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MENTAL HEALTH, TRAUMA AND RECOVERY
References
Bazari, M., Farahani, M. M., & Vatankhah, H. R. (2019). THE EFFECTIVENESS OF
COGNITIVE-BEHAVIORAL THERAPY IN SUICIDAL IDEATION AND EARLY
MALADAPTIVE SCHEMAS OF THE GIRLS REFERRING TO THE SOCIAL
EMERGENCY OF THE COUNTRY. Humanidades & Inovação, 6(12), 262-269.
Berberian, M., Walker, M. S., & Kaimal, G. (2019). ‘Master My Demons’: art therapy
montage paintings by active-duty military service members with traumatic brain
injury and post-traumatic stress. Medical humanities, 45(4), 353-360.
Chaves, C., Lopez-Gomez, I., Hervas, G., & Vazquez, C. (2017). A comparative study on the
efficacy of a positive psychology intervention and a cognitive behavioral therapy for
clinical depression. Cognitive Therapy and Research, 41(3), 417-433.
Driessen, E., Smits, N., Dekker, J. J. M., Peen, J., Don, F. J., Kool, S., ... & Van, H. L.
(2016). Differential efficacy of cognitive behavioral therapy and psychodynamic
therapy for major depression: a study of prescriptive factors. Psychological
medicine, 46(4), 731-744.
Karyotaki, E., Riper, H., Twisk, J., Hoogendoorn, A., Kleiboer, A., Mira, A., ... & Andersson,
G. (2017). Efficacy of self-guided internet-based cognitive behavioral therapy in the
treatment of depressive symptoms: a meta-analysis of individual participant
data. JAMA psychiatry, 74(4), 351-359.

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MENTAL HEALTH, TRAUMA AND RECOVERY
Ugurlu, N., Akca, L., & Acarturk, C. (2016). An art therapy intervention for symptoms of
post-traumatic stress, depression and anxiety among Syrian refugee
children. Vulnerable children and youth studies, 11(2), 89-102.